Buurtzorg is a Dutch home health care and neighbourhood nursing company founded by Jos de Blok in 2006. de Blok’s leadership philosophy has been fundamental for the company’s growth expanding from 10 to 8000 nurses in 2014.
WHY IS IT AN INTERESTING CASE STORY?
de Blok has created the company as a network of self-managing teams where 10-12 nurses serve clients in small local areas, typically taking care of roughly 50 clients. This approach is in stark contrast to the rest of the industry, where support functions are centralised and nurses switch between hundreds of clients to fulfil efficiency objectives.
One of de Blok’s mottos is ‘humanity over bureaucracy’ and this purpose permeate the organisation. Nurses give attention to clients even if it is not strictly the type of care they provide, i.e. nurses make the time to have a cup of coffee or a conversation with the patients. A few more principles standout; all teams are self-organising and responsibilities and tasks must be equally distributed. Beyond the committing to a number of tasks nurses should build up an expertise and connect with other nurses outside their own team and share their knowledge either through the intranet or physical meet ups when possible. Lastly, if teams need to have more than 12 nurses to serve a neighbourhood, then the team should split in two.
Organisations driven by purpose can mobilise an energised workforce and improve productivity as a spill off effect.
Technology can connect a distributed workforce and surface experts in the organisation.
Leaders can involve and interact with associates via technology.
Self-managing: No teams have a boss and everyone in the teams are nurses. To prepare new nurses for self-management Buurtzorg runs a training course called “Solution-Driven Methods of Interaction” for all new joiners. In this course the nurses learn skills and techniques needed for healthy and efficient group decision-making, including different ways of communicating with colleagues and clients.
Impartial facilitator meeting method: Buurtzorg have created their own technique for dealing with tensions and group decision-making. The most important element of the technique is the facilitator, which can be any of the team members who have all learned about facilitating in an introduction course. A quite unique aspect of Buurtzorg meeting method is that if a team gets stuck on a topic they will openly share their issue with the rest of the company via their intranet and look for outside input.
Working out loud: de Blok designed the operating model to use “BuurtzorgWeb” as a central part of the governance. The BuurtzorgWeb is vital for sharing the nurse’ expert knowledge, creating and iterating on best practices.
Leaders working out loud: de Blok also use the BuurtzorgWeb as his primary tool for leading the organisation. Via the internal platform de Blok provides updates on the business and involves the nurses in sense and decision-making. One story goes that Buurtzorg was struggling with the cash flow and de Blok chose to blog about the problem and suggesting two solutions; temporarily stop growing or increasing productivity. Through the conversation that spun off in the comments the nurses collectively decided take in more work for a period to create the cash needed to support the growth.
Situational hierarchy: While the organisation is organised as flat structure some nurses gain recognition in the company through their activities and expertise. Consequently the nurses that build up influence often consult others nurses, but this is an organically developed hierarchy of trust.
360 feedback: Buurtzorg teams do regular coaching meetings to work through tensions and once a year all team members do a 360 appraisal of their team members. However, compared to most other businesses the teams can design their own competency models that they wish to use for appraisals.
Reinventing Organisations by Frederic Laloux
Home Care by Self-Governing Nursing Teams: The Netherlands’ Buurtzorg Model by The Common Wealthfund
Netherlands: Buurtzorg empowered nurses focus on patient value by KPMG
Jos de Blok on Organisational Structures by RSA Spotlight
"The Four Principles of Network Entrepreneurship
We have found that despite huge differences in issue area, scale, resources, and formal roles, network entrepreneurs and their networks are remarkably similar. The networks that network entrepreneurs catalyze all demonstrate the following four operating principles:
Trust not control. Strong relationships among network partners and a culture in which actors routinely invest resources into building long-term, trust-based relationships—without the expectation of control or even recognition—is critical to collaborative success. Network entrepreneurs emphasize “return on relationships” above all else. Unless they are built on a foundation of mutual respect and integrity, collaborations are unlikely to succeed, regardless of how much formal structure or strategic planning went into them.
Humility not brand. Unlike social entrepreneurs so often held up as hero-like figures, network entrepreneurs are largely anonymous by design. Early in a network’s development, these leaders are important visionaries, and stewards who help foster a healthy network culture and develop a sustainable structure. But they are deliberate about ceding their power to the collective leadership of the network and instead developing leadership capacity throughout the network.
Node not hub. Network entrepreneurs are keenly aware that they are few among many working across the larger system, and in this way they embody a special type of system leader, powerfully articulated by Senge, Hamilton, and Kania in a recent SSIR article. Networks entrepreneurs not only connect to the larger system around them and foster generative conversation, but also deliberately catalyze and lead action-oriented networks that are aligned around a defined shared purpose and built on the foundation of deep relationship. They develop a culture where no individual or organization seeks to be the brightest star. Partners and peers mobilize a constellation of resources and skills that enables the achievement of a shared vision. The network becomes the primary vehicle for delivering mission impact. Consequently, there is as much focus on engaging trusted peers outside the network entrepreneur’s organization as there is on tasks within the organization.
Mission not organization. Network entrepreneurs are far more motivated to achieve maximum impact than to advance themselves or their organizations. The network entrepreneur acts as a participant, eschewing personal or organizational status in service to the mission. They often put the interests of their peers ahead of their own, as “supporting all boats to rise” actually serves the mission best. Network entrepreneurs, for example, often refer potential donors to peers that can better deliver a program or service; they don’t simply seek to maximize their own organization’s budget. When all network participants adhere to this principle, it becomes self-reinforcing; it greases the wheels of current collaborations and opens the doors to future partnerships."
"Wealth has declined
There’s also a harsh reality behind it: Independent workers simply have less money to spend. Their careers are unpredictable in terms of hours, income, and even location. So when they do spend, they're turning to alternatives like sharing or renting rather than buying. In a recent report from PriceWaterhouseCoopers, 86% of people surveyed said that using a ride-sharing app or renting out someone's spare room rather than booking a hotel "makes life more affordable." More than 80% said it was "less expensive to share goods than to own them individually." And 43% went as far as to say that "owning, today, feels like a burden."
"The ranks of independent workers continue to grow. But as long as their incomes continue to shrink, so will their spending."
That kind of meaningful independence is a social and economic movement that’s not going away. It's a relief for many of today’s new-wave workers, who can’t afford up-front costs of big-ticket items. But it’s not so helpful in addressing the underlying problem that income inequality in this country is very real and growing worse."
"What kind of economic environment would make the best use of the new digital technologies?
McAfee: One that’s conducive to innovation, new business formation, and economic growth. To create it, we need to focus on five things:
The first is education. Primary and secondary education systems should be teaching relevant and valuable skills, which means things computers are not good at. These include creativity, interpersonal skills, and problem solving.
The second is infrastructure. World-class roads, airports, and networks are investments in the future and the foundations of growth.
Third, we need more entrepreneurship. Young businesses, especially fast-growing ones, are a prime source of new jobs. But most industries and regions are seeing fewer new companies than they did three decades ago.
A fourth focus is immigration. Many of the world’s most talented people come to America to build lives and careers, and there’s clear evidence that immigrant-founded companies have been great job-creation engines. The current policies in this area are far too restrictive, and our procedures are nightmarishly bureaucratic.
The fifth thing is basic research. Companies tend to concentrate on applied research, which means that the government has a role to play in supporting original early-stage research. Most of today’s tech marvels, from the internet to the smartphone, have a government program somewhere in their family tree. Funding for basic research in America, though, is on the decline: Both total and nondefense federal R&D spending, as percentages of GDP, have declined by more than a third since 1980. That must change.
"I’ve mentioned in previous posts that I am really interested in the marketing industry, specifically content marketing and branding, as I think there are some things that they do really well that can apply to the learning landscape and vice versa. Now that I am getting into a PKM routine my attention has started to shift more in this direction. Here is what I noticed this week:
A post by Seth Godin (former VP of Direct Marketing at Yahoo and bestselling author) found via Feedly on giving people what the want: This post, to me, is a reminder of what value we can add to those in the marketing industry. Seth sums it up nicely:
“Don’t say, “I wish people wanted this.” Sure, it’s great if the market already wants what you make… Instead, imagine what would happen if you could teach them why they should.”
A post on the hottest Uber links by Marshall Kirkpatrick who runs Little Bird (a company thatcreatesinfluencer discovery and engagement tools) found. Two things struck me as interesting:
Marshall chose to work out loud and share his links with the world instead of emailing them to a friend. I just tlove finding examples of others outside the L&D industry using the term “work out loud.” It means it’s resonating!
Marshall mapped the Uber community (using Little Bird) to find the most influential members of that community online and see what they are talking about. It had me wondering how software like this could help people trying to build their personal learning networks.
A tweet by Jane Hart linking to an article by Tom Spiglanin on the demise of the e-learning brand. I love seeing others in the L&D indutry make the marketing connection as well. This also made me ponder what e-learning would look like if we had actually followed the brand principles he outlined from the start.
"the e-learning brand has eroded, become diluted, & has therefore outlived its usefulness" http://t.co/4LgaMivb1G <grt piece @tomspiglanin
— Jane Hart (C4LPT) (@C4LPT) February 5, 2015"
"There are many contributing factors that have led to our current economic system and continued acceptance of the 40-hour workweek, three major factors being consumerism, inflation, and debt"
"“Celebrity Freelancer” is my pet name for those internet-famous “gurus” who don’t seem to do much, besides spending 20 hours a day online, trying to get people to buy their e-books, speaking gigs or in my case, fine art.
For people stuck in office jobs they despise, being a “Celebrity Freelancer” sounds like a pretty sweet deal, until you actually have to do it. Having to be “interesting” every day and pimping all the time via your blog is actually a pretty demeaning and soul-destroying way to spend one’s life. After a couple of months you start hating yourself. Nein danke.
Some boring advice for young artistsIn "meta"
On cartooningIn "cartoons"
gapingvoid in IsraelIn "2014"
gapingvoid in Israel →
[This is strictly my personal blog. My work blog is over at gapingvoid.com.]
Since 1997 I've been drawing cartoons on the back of business cards, just to give me something to do while sitting at the bar.
So far, I have drawn over 10,000 of them.
The mission of hughcartoons.com is to document and archive every single one of the ten-thousand-plus cards I've drawn since 1997, plus any other cartoons, ideas and writings I care to share with the world. Documenting the cards is a mammoth task, but it’ll to be an amazing body of work, once it’s done.
I've been regularly showing the cards individually over at the gapingvoid.com since 2001.
The vast majority of the cards are India ink on acid-free card stock (Strathmore 400 vellum bristol board), cut to standard business-card size.
The cards are generally not for sale, because I want to keep the collection as intact as impossible.
I like getting emails from y'all: email@example.com.
I’ll be regualrly updating the site with new work, as events unfold etc.
Thanks for visiting,
- Hugh MacLeod
"Ton may have started her research in retail, but she believes her core findings are relevant in nearly every industry. After re-evaluating the relationship between worker management and profit, she argues that many corporate leaders will realize that paying their workers more and treating them better will actually make everyone better off. And this, indeed, would foment a small revolution. For generations, technology has been a source of misery for many low-paid workers, rendering their jobs tedious or eliminating them altogether. Gallup recently reported that only 29 percent of North American workers feel engaged with their work. Yet Ton suggests that a more sophisticated use of those same technological tools could reverse those trends. It’s possible that the lousy commodity jobs that we think of as central to an industrialized economy — from Charlie Chaplin’s “Modern Times” to “Office Space” to the latest disaster in Bangladesh — may not be a sad but inevitable result of a bigger, more efficient economy; it may just be a math error. Ikea’s decision to improve conditions for its workers is a major step forward. Persuading Walmart, with its 1.3 million U.S. employees . . . well, that might be a revolution."
"A growing talent gap that’s getting wider with more than half of employees surveyed feeling that their company provides inadequate training on technology, despite an acceptance that demand for skills like analytics and programming/development will grow sizeably over the next three years. Worse, less than one-third say their company makes the latest technology available to them.
Lack of leadership is to blame for all all this, with executives citing lack of access to strong leaders as the number two impediment to achieving their goals of building a workforce to meet future business objectives. Under a third of executives interviewed reckon that they would be able to replace a skilled departing employee from within the organization, with most of them believing that their own leaders don’t the skills to manage talent or inspire employees.
Workforce transience over permanence as the emergence of the ‘as a service’ economy leads to organizations tapping into freelance external contractors and resources to plug gaps and deliver ‘as needed’ skills. This clearly impacts on the nature of the workforce which becomes more fluid and less permanent. This one isn’t going to change though as 83% of executives state they plan to use more and more ‘consulting employees’."
"Our recent social business report suggested that 67% of executives thought that social media had the opportunity to fundamentally change their businesses. The number was higher for companies that were deriving greater business value from these technologies. Compelling reasons, rooted in fundamental concepts of economics and business strategy, support this belief that social media will fundamentally reshape not only individual organizations, but also the business environment as a whole."
So what does it take to be a job maximizer?
Choose Your Talent. Who do you want to employ? AutonomyWorks focuses on people with autism. Shinola focuses on former auto workers. There are many other segments of the labor force who are underemployed or underutilized.
Find Your Market. What products or services can these workers best make or provide? This is where the entrepreneurial magic comes into play. You need to find something that suits your people and also generates a sustainable profit. Friedman recommends looking for markets where work has been off-shored or automated, and that have low capital requirements.
Design Your System. What innovations do you need to meet the unique needs and bring out the best in your workers? This might involve rethinking hiring, process design, management, or organizational culture. The key is turning people’s disadvantage in society into your company’s competitive advantage in the marketplace.
Over the last twenty years, we have successfully created an entirely new economic sector in which social entrepreneurs maximize purpose over profit. It’s time to turn this entrepreneurial spirit on a new goal: job creation. We need more people like Dave Friedman and more companies like Shinola — job maximizers and employment entrepreneurs.
In the chart you can see that in the US in the 1980s there was strong growth in high-skill jobs and a reduction in low-skill jobs, in the 1990s there was massive growth in high-skill jobs and a little growth in low-skill jobs, and in 1999-2007 there was high growth in low-skill jobs and a little growth in high-skill jobs.
At no point was there growth in middle-skilled jobs.
The Corporation is at Odds with the Future<br /><br />by Grant McCracken | 1:00 PM May 29, 2013<br /><br /> Comments
A client recently asked me to comment crisply on the future. I came up with these observations.<br /><br />See if you can spot my error.<br /><br /> The world is speeding up. In 1989, Alan Kay said it takes at least 10 years for an innovation to get from the lab into everyday life. Twitter did it in 4.<br /> Faster change means more turbulence. Assumptions are now less reliable. Best guesses are often shots in the dark. Planning sounds like an act of courage, strategy like a flight of imagination. When Alvin Toffler warned us of this in 1970, we scoffed. Now we're living it.<br /> Every individual and organization lives in a state of surprise, as Peter Schwartz puts it. Just a couple of years ago, professional planners at a big ad agency informed me that Twitter was a passing fancy. So I was interested to note that the first thing LL Cool J did as host of the Emmy's this year was announce the hashtags for the show. Boy, was that agency surprised.<br /> There is a considerable advantage to seeing the world in motion, picking up "noise" well before it becomes an intelligible "signal." We have to extract more intelligence from less data. We will need "big data" and good ethnography to spot and track the world in the works. For instance, this would have meant grasping the fact (and some of the implications) of Twitter in, say, 1998.<br /><br /> And what we really need is a more responsive organization, one that can reinvent itself in real time, on the fly. This will take potent, new powers of adaptation, but it's our only hope.<br /><br />Spot the error?<br /><br />I carried my assumptions into the future. I continued to think about the corporation as I normally do... and resolved merely to retrofit it with new parts in order to make it more sensing and more responsive in the future.<br /><br />Boo! No, really, I mean it. Boo! Bad anthropologist. Bad!<br /><br />What I should have done is examine my idea of a corporation, dig out the assumptions, and re-craft the idea. That's one of the ways we make ourselves ready for the future.<br /><br />Here is my present idea of the corporation, give or take. The corporation is a thing of people, processes, places, and products (give or take). And these 4 Ps are relatively well-defined, organized, boundaried, and anchored (more or less).<br /><br />But that's a problem. This corporation is deeply at odds with the future. Because the future is never defined, organized, boundaried, or anchored. Really, it's all just hints and whispers. Fragile melody, no refrain.<br /><br />Hence, the great antagonism between corporations and time. A creature that defines itself out of definition, organization, boundary, and anchoring, must hate a future that is shapeless and unmoored. To the corporations, the future looks like the enemy, a risk that can't be managed, an idea that can't be thought.<br /><br />The corporation puts a particular boundary between now and the future. And it guards this border ferociously. New ideas are scrutinized with tough mindedness and high indignation. If we can't see the business model, we're not interested. If we can't see how to "monitize this sucker," we're not interested. When the future manifests itself merely as a murmur of possibility, we are not interested.<br /><br />Too bad. There is really only one way to live in a world of speed, surprise, noise, and responsiveness, and that's to visit the future frequently. And, if we have the intellectual capital, maybe get a pied-à-terre. Well, and if we're really committed, we need someone to take up residence full time.<br /><br />Most of all, we want a corporation that is porous in ways it was not before. We want it to cantilever out into the future. We want to make pieces of the future to happen inside the corporation. We want pieces of the corporation to happen out there in the future. In sum, we want the corporation and the future, once so completely separated from one another, to have a new reciprocity and transparency.<br /><br />It's a weird idea, counter-intuitive in exactly the ways that provoke suspicion and dismissal. And it is an idea that will make a hash of the model of the corporation we mostly keep in our heads. But honestly, we have no real choice.
Within the last quarter century, intellectual capital has emerged as the leading asset class. The term "intellectual captial" refers generally to traditional intellectual property assets - patents, trademarks and copyrights. At Ocean Tomo, we uniquely include within the definition of "intellectual capital" special client intangible assets, especially corporate and government preference rights.<br /><br />Recent and anticipated changes in accounting rules and securities reporting will further the recognition of intangible assets. The growth in the value of Intellectual Capital Equity® can be seen when evaluating the market capitalization of the S&P 500 as shown in the chart below.
In a special issue of the journal Long Range Planning, Charles Baden-Fuller and Mary Morgan say that business models can serve three different purposes. They can describe different kinds and types of businesses. This is critical if we are trying to study them analytically. They can be short-hand descriptions of how firms operate – the primary value here is that you can use the business model to ensure that you have strategic fit across activities. Or they can be role models – you can use them to describe how you want your organisation to function.<br /><br />More recently, Steve Blank has added another use – he says that business models are hypotheses about how your organisation might be able to create value for customers (see my discussion of this here).
Based on my experience, there are at least three (largely unintentional) reasons why managers send mixed messages about innovation.
First, managers need immediate results, often reinforced by short-term incentive plans or the regular expectation of earnings improvements. Innovation may take a long time to produce returns, which conflicts with these short-term requirements. So even though managers know that innovation is necessary, most do not have the patience to wait years for results. Consequently, they say that innovation is important, but they don't back it up with time or resources.
Managers may also fear that innovation will cannibalize current business. I've seen managers slow down investments in new products because customers might switch to something less expensive or longer-lasting, or otherwise impact existing results. In other words, while managers might want to disrupt their competitors, they are less comfortable disrupting themselves.
Additionally, managers are often schooled in slow, continuous improvement. Approaches like Six Sigma have helped companies squeeze out inefficiencies, but also tend to reinforce existing processes with an eye towards doing them better. On the other hand, innovation requires messy experiments instead of methodical analysis. As a result, managers who have grown up in a continuous-improvement culture may be uncomfortable with change that doesn't happen step-by-step.
If you recognize these mixed messages in your organization, here are a couple of ideas for picking up the pace of innovation:
Talk about how innovation is avoided. Politely and respectfully ask your manager or senior team about their commitment to innovation. Share the mixed messages you've perceived and provide examples of missed innovation opportunities. Remember that most managers are not intentionally trying to prevent innovation — so discussing the dilemmas will make decision-makers more conscious of them.
Work on innovation with colleagues. Instead of working alone, partner with co-workers to achieve an explicit innovation goal. For example, one divisional leadership team decided to spend every Friday morning focusing on how they could develop business for "the year after." By carving out the time, and reinforcing to each other the legitimacy of working on something without a short-term payoff, they were able to make more progress than any of them could have made alone.
This is an alphabetical list of over 100 websites for learning about all aspects of business - strategy, management, leadership, marketing, finance, accounting, economics, as well as business skills. It includes a range of sites suitable for both business studies education, workplace learning, and for educators, learners and managers alike. The sites include both formal and informal learning resources – games, podcasts, blogs, videos, books, PDFs, as well as online courses, communities and other general resources. [Email additions to the list]
In today’s manufacturing plants, information systems are usually very hierarchical and depend on predetermined rules. As manufacturing systems become more complex, it will become much more difficult for individuals to spot small deviations and trends within the system. This means that factories, in a way, will need to become “self-aware” in order to support optimized systems. This self-awareness will cause transformations in the way people work. There will be far greater use of simulation to look at the manufacturing systems’ ability to react to changes, such as the introduction of a new product or factory rearrangement. The line between the virtual and physical world will also start to blur, forcing most manufacturing engineers to become more adept at dealing with virtual control systems simulation and other such technologies.
Umberto Eco proclaimed that:
"The list is the origin of culture. It’s part of the history of art and literature. What does culture want? To make infinity comprehensible.
It also wants to create order — not always, but often. And how, as a human being, does one face infinity?
How does one attempt to grasp the incomprehensible? Through lists, through catalogs, through collections in museums and through encyclopedias and dictionaries.
There is an allure to enumerating how many women Don Giovanni slept with: It was 2,063, at least according to Mozart’s librettist, Lorenzo da Ponte.
We also have completely practical lists — the shopping list, the will, the menu — that are also cultural achievements in their own right.” ~ Umberto Eco [hat tip Maria Popova]
We like lists because we want to matter.
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